Key result
Paclitaxel, sirolimus, and zotarolimus stents show comparable 12-month MACE in STEMI patients with metabolic syndrome.
Why the study?
The comparative efficacy and safety of paclitaxel-, sirolimus-, and zotarolimus-eluting stents in primary PCI for STEMI patients with metabolic syndrome were not well established.
Does the choice between paclitaxel-, sirolimus-, or zotarolimus-eluting stents affect clinical outcomes in patients with STEMI and metabolic syndrome undergoing primary PCI?
Observational (n=1,768)
Yes
Does the choice between paclitaxel-, sirolimus-, or zotarolimus-eluting stents affect clinical outcomes in patients with STEMI and metabolic syndrome undergoing primary PCI?
p-value: p=0.086
In patients with STEMI and metabolic syndrome undergoing primary PCI, the use of paclitaxel-, sirolimus-, or zotarolimus-eluting stents provides comparable 12-month clinical outcomes.
May support flexible stent selection in metabolic syndrome STEMI; leaves open need for randomized confirmation.
BACKGROUND: The purpose of the present study was to compare the efficacy and safety of paclitaxel-eluting stent (PES), sirolimus-eluting stent (SES), and zotarolimus-eluting stent (ZES) in primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI) with metabolic syndrome (MS). METHODS AND RESULTS: Using data from Korea Acute Myocardial Infarction Registry (KAMIR; November 2005-December 2007), a total of 1,768 MS patients with STEMI who underwent primary PCI were enrolled: The PES group was 634, SES group, 906, and ZES group, 228. The primary endpoint was major adverse cardiac event (all-cause death, re-myocardial infarction, target lesion revascularization) during 12 months follow-up. At 12 months, the cumulative incidence of primary endpoint in the PES, SES, and ZES groups was 10.9%, 9.1%, and 11.0%, respectively (P=0.086). Incidence of death, recurrent myocardial infarction, or target lesion revascularization did not differ among the 3 groups. There were 7 episodes of acute (0.3% in PES group, 0.4% in SES group, and 0.4% in ZES group, respectively, P=0.773) and 18 episodes of cumulative stent thrombosis including late stent thrombosis (0.9% in PES group, 1.0% in SES group, and 1.3% in ZES group, respectively, P=0.448). CONCLUSIONS: Implantation of SES, PES, and ZES in MS patients with STEMI undergoing primary PCI provided comparable clinical outcomes in patients enrolled in KAMIR.
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Lee et al. (2011) conducted an observational in Acute ST-Segment Elevation Myocardial Infarction (STEMI) with Metabolic Syndrome (n=1,768). Paclitaxel-, sirolimus-, and zotarolimus-eluting stents vs. Compared against each other was evaluated on Major adverse cardiac event (composite of all-cause death, re-myocardial infarction, and target lesion revascularization) (p=0.086). In STEMI patients with metabolic syndrome, paclitaxel-, sirolimus-, and zotarolimus-eluting stents yielded comparable 12-month major adverse cardiac event rates (10.9%, 9.1%, and 11.0%; P=0.086).
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